How does a state comply with this assurance?
Many states comply with this assurance through the establishment of a critical incident reporting system. Often these systems define critical incidents more broadly than abuse, neglect and exploitation. (click here for more information about critical incidents)
Whether specific to abuse, neglect and exploitation or inclusive of more broadly defined critical events, a state:
- Defines the events and circumstances that are serious in nature and must be reported to the state.
- Assesses the risk for abuse or other serious incidents during the service planning process. States usually provide guidance on how to identify a participant’s potential areas of vulnerability and the proactive steps that should be taken in the service plan to mitigate their occurrence.
- Tracks, investigates and resolves reports of abuse, neglect and exploitation as well as other critical incidents.
Many states require that suspicions of abuse, neglect and exploitation be reported directly to Protective Services, which has the investigative and enforcement authority to take swift action. (click here for more information about protective services)
States must also:
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Assure that participants (and involved family or other unpaid caregivers, as appropriate) are informed about their rights and protections, including how they can safely report an event and receive the necessary intervention or support.
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Assure that HCBS waiver agencies, vendors and workers (including case managers) are well informed of their responsibilities to identify and report all critical incidents. Provider responsibilities are typically described in licensure requirements, contracts or service agreements, job descriptions and agency policies. Responsibilities are also reinforced through periodic state training.
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Evaluate the nature, frequency and circumstances of reported cases and determine how the HCBS waiver can prevent or reduce similar occurrences in the future.
